Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Ethan Vandersand

Individual provider Pharmacist · NPI 1316297088

Ethan Vandersand is a Pharmacist in Jerseyville, Illinois. Licensed in Illinois. Registered with an NPI since 2012.

Licensed in
IL
In the registry since
2012
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Practice location Address checks out

400A W Carpenter St
Jerseyville, IL 62052-2522
Phone: (618) 498-6461
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pharmacist (primary) Taxonomy 183500000X · Licence 051-289033 (IL)

Record details

NPI number1316297088
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedSeptember 10, 2012
Last updated in NPPESSeptember 10, 2012
Mailing addressRr 1 Box 128, White Hall, IL 62092-9713

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